In last month’s article, we discussed how better patient communication can help prevent missed appointments and improve follow-up. One of the safest and most convenient methods of communication with established patients is a portal. A patient portal is a secure online website that gives patients 24-hour access to personal health information. In addition to the benefits of security and convenience, portals allow patients to take “ownership” of their healthcare by taking a more active role. Other benefits include enhanced documentation of communication with a patient in the medical record and improved continuity of care as communication among multiple providers is likewise improved as they can easily review prior communications between the other providers and the patient. During the COVID-19 pandemic, portals can play an even more important role as they allow physicians and staff to work remotely while providing care to the patient using real-time information. Portals promote efficiency by reducing the amount of time expended in telephone interaction, medication refills, mailing appointment reminders, etc. A great deal of the staff’s and provider’s time is wasted each day playing phone-tag with patients or family members. A portal can help eliminate this wasted time.
As reported in the national news this year, patients (including the parents of minor children) have expressed reluctance to schedule appointments for routine vaccinations and flu shots because they are afraid of exposing themselves and their children to COVID-19 in the physicians’ offices. The portal is an excellent tool to communicate to existing patients the steps the practice is taking to reduce the likelihood of exposure to COVID-19 and to remind them of the importance of maintaining schedules and, especially this year, getting a flu shot.
A question we are frequently asked at SVMIC is, “Can normal test results be communicated to the patient via the portal?” The answer is a qualified “yes.” It is qualified because certain requirements must be met in order to protect the provider.
Every practice should have a consistent method for notifying all patients of all test results and instructing them to call the practice if they have not received the results within the expected time frame. These instructions to the patients, as well as the actual patient notification, should be documented in the medical record. Although instructing the patient to call for test results does not absolve the doctor of the duty to inform the patient, it does act as an additional safety net to ensure that important test results do not get overlooked and is a legitimate means of involving the patient in his or her own healthcare. The more layers of redundancy that can be built into a system, the better.
Practices can make use of electronic patient portals for notification of normal, non-sensitive test results for those patients who have signed a written consent or electronically agreed to receive information via the portal, provided the patient has accessed the portal on at least one previous occasion. However, it is not reasonable to assume all patients are able or choose to use the portal. Practices should have a means of verifying that patients have accessed the portal before utilizing it as the sole vehicle of notification of normal, non-sensitive results. In other words, before sending normal non-sensitive test results to patients using the portal, the provider must first determine that, at some time the past, the patient has accessed information using the portal.
Patients who have not used the portal previously should be notified of normal test results through another means. It is not acceptable, from a risk or customer service perspective, to advise patients that the only method of normal non-sensitive test notification available will be through the portal.
Any patient with an abnormal test result, a report that contains sensitive information (i.e. pregnancy tests, STD tests, etc.), or a result requiring immediate action should be personally notified, and those results should not be posted to the portal prior to patient notification. Additionally, if the abnormal results include potentially serious or unanticipated consequences, the results should be communicated directly to the patient by the provider rather than a staff member. The notification to the patient should be documented in the EHR.
If you have any questions about the use of a portal or other risk-related issues, please contact SVMIC at ContactSVMIC@svmic.com or 800.342.2239.
Jeffrey A. Woods is the Director of Risk Education in the Risk Education and Evaluation Services Department at SVMIC. Jeff received his Bachelor of Science degree from the University of Tennessee Martin and his Juris Doctorate degree from the University of Tennessee Knoxville. Following graduation, he practiced law in Knoxville for almost 15 years, advising physicians and healthcare providers and defending them in malpractice claims. He is licensed to practice in Tennessee and all Federal courts, including the United States Supreme Court. He is a member of the Tennessee Bar Association.
Jeff joined SVMIC in 2003 and was a Senior Claims Attorney until 2015 when he transferred to his current position.
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